Master Chemotherapy Regimen Reference (Oncology Pharmacy)
| Cancer Type | Regimen Name | Components | Cycle Length | Hallmark Toxicities / Pearls |
|---|---|---|---|---|
| Colorectal | FOLFOX | 5-FU + Leucovorin + Oxaliplatin | q2w | Neuropathy (oxaliplatin), myelosuppression, mucositis |
| CAPOX (XELOX) | Capecitabine + Oxaliplatin | q3w | Oral option, hand–foot syndrome, renal adjust capecitabine | |
| FOLFIRI | 5-FU + Leucovorin + Irinotecan | q2w | Diarrhea (irinotecan), neutropenia | |
| FOLFOXIRI | 5-FU + Leucovorin + Oxaliplatin + Irinotecan | q2w | Intensive; higher GI toxicity & myelosuppression | |
| Breast | AC | Doxorubicin + Cyclophosphamide | q3w × 4 | Cardiotoxicity, myelosuppression, alopecia |
| AC → T | AC followed by Paclitaxel | Sequential | Adds neuropathy & hypersensitivity from taxane | |
| TC | Docetaxel + Cyclophosphamide | q3w | Alternative to anthracyclines | |
| TCH | Docetaxel + Carboplatin + Trastuzumab | q3w | HER2+, less cardiotoxic than anthracyclines | |
| TCHP | Docetaxel + Carboplatin + Trastuzumab + Pertuzumab | q3w | HER2+; neoadjuvant/adjuvant | |
| NSCLC | Carbo + Pemetrexed ± Pembrolizumab | Carboplatin + Pemetrexed ± IO | q3w | Non-squamous only; nephrotoxicity, cytopenias |
| Carbo + Taxane ± Pembrolizumab | Carboplatin + Paclitaxel/nab-Paclitaxel ± IO | q3w | Squamous NSCLC (KEYNOTE-407) | |
| SCLC | EP | Etoposide + Cisplatin (or Carboplatin) | q3w | Standard 1st-line; nausea, myelosuppression |
| IP | Irinotecan + Cisplatin | q3w | Alternative in extensive stage | |
| Gastric / GEJ | FLOT | 5-FU + Leucovorin + Oxaliplatin + Docetaxel | q2w | Standard perioperative (FLOT4 trial) |
| EOX / ECX / ECF | Epirubicin + Oxaliplatin/Cisplatin + Capecitabine/5-FU | q3w | Replaced largely by FLOT | |
| Esophageal | CROSS | Carboplatin + Paclitaxel + Radiation | q1w × 5 | Neoadjuvant chemoradiation |
| Pancreatic | FOLFIRINOX | 5-FU + Leucovorin + Irinotecan + Oxaliplatin | q2w | Fit pts; high toxicity; diarrhea, neuropathy |
| Gem + nab-Paclitaxel | Gemcitabine + nab-Paclitaxel | q1w (3/4 wks) | Neuropathy, cytopenias | |
| Head & Neck SCC | EXTREME | Cetuximab + Cis/Carbo + 5-FU | q3w | Recurrent/metastatic; mucositis, rash (EGFR) |
| TPF | Docetaxel + Cisplatin + 5-FU | q3w | Induction chemo for advanced | |
| Cervical | Cisplatin + Paclitaxel + Bevacizumab | — | q3w | 1st-line recurrent/metastatic |
| Carbo + Paclitaxel + Pembrolizumab | — | q3w | KEYNOTE-826; IO incorporated | |
| Bladder | MVAC | MTX + Vinblastine + Doxorubicin + Cisplatin | q4w | Old standard; very toxic |
| Gem-Cis | Gemcitabine + Cisplatin | q3w | Modern 1st-line advanced disease | |
| Prostate | Docetaxel + ADT | Docetaxel + Androgen deprivation | q3w × 6 | For high-volume mCSPC |
| Triplet (PEACE-1, ARASENS) | ADT + Docetaxel + Abiraterone or Darolutamide | q3w + continuous oral | Improves OS; monitor LFTs, HTN | |
| Lymphoma (DLBCL) | R-CHOP | Rituximab + Cyclophosphamide + Doxorubicin + Vincristine + Prednisone | q3w × 6 | Curative; cardiotoxicity, neuropathy |
| R-EPOCH | Rituximab + Etoposide + Prednisone + Vincristine + Cyclophosphamide + Doxorubicin | q3w (infusional) | Used in double-hit DLBCL | |
| Hodgkin | ABVD | Doxorubicin + Bleomycin + Vinblastine + Dacarbazine | q2w | Pulmonary fibrosis (bleomycin), cardiotoxicity |
| BEACOPP | Bleomycin + Etoposide + Doxorubicin + Cyclophosphamide + Vincristine + Procarbazine + Prednisone | q3w | Escalated regimen; more toxic | |
| Testicular | BEP | Bleomycin + Etoposide + Cisplatin | q3w | Curative; monitor lungs & kidneys |
| EP | Etoposide + Cisplatin | q3w | Used if bleomycin contraindicated | |
| Ovarian | Carbo-Taxol | Carboplatin + Paclitaxel | q3w | 1st-line; neuropathy, cytopenias |
| AML | 7+3 | Cytarabine (7 d) + Anthracycline (3 d) | Induction | Myelosuppression, mucositis, cardiotoxicity |
| FLAG-IDA | Fludarabine + Cytarabine + G-CSF + Idarubicin | Salvage | Intensive salvage regimen | |
| ALL | Hyper-CVAD | Cyclophosphamide + Vincristine + Doxorubicin + Dexamethasone / alternate with MTX + Cytarabine | q21d | Complex; TLS risk; infection prophylaxis crucial |
| CALGB 10403 | Vincristine, Steroids, Asparaginase, MTX, 6-MP | Pediatric-inspired AYA regimen | Higher cure rates in young adults | |
| Multiple Myeloma | VRd | Bortezomib + Lenalidomide + Dexamethasone | q3–4w | Neuropathy, cytopenias, VTE risk |
| CyBorD | Cyclophosphamide + Bortezomib + Dexamethasone | q3w | Alternative induction | |
| Sarcoma (Soft Tissue) | AIM | Doxorubicin + Ifosfamide + Mesna | q3w | Standard for high-grade; nephro/neurotoxicity (ifos) |
| Osteosarcoma | MAP | MTX (HD) + Doxorubicin + Cisplatin | Multi-cycle | Pediatric/AYA standard |
| Ewing Sarcoma | VDC/IE | Vincristine + Doxorubicin + Cyclophosphamide alternating with Ifosfamide + Etoposide | q2w | Dose-dense; pediatric/AYA |
| Wilms Tumor | EE-4A | Vincristine + Actinomycin D | — | Low-risk |
| DD-4A | Vincristine + Actinomycin D + Doxorubicin | — | Higher-risk |
Key Takeaway for Oncology Pharmacists
- Regimen names are mnemonics (FOLFOX = Folinic acid, 5-FU, Oxaliplatin; R-CHOP = Rituximab, Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone).
- Toxicities often come from the unique drug in the combination (e.g., oxaliplatin → neuropathy, bleomycin → pulmonary toxicity).
- Supportive care (antiemetics, growth factors, hydration, TLS prophylaxis) is essential in regimen management.